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Mitral Regurgitation
Daniel W. Entrikin, MD; Gudrun Feuchtner, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Mitral regurgitation (MR)
              • Left ventricular stroke volume (LVSV)
            • Synonyms

              • Mitral insufficiency
            • Definitions

              • MR: Incomplete closure of mitral valve (MV) during systole resulting in retrograde blood flow into left atrium (LA)
              • Mitral valve prolapse (MVP): Systolic movement of valve leaflet into LA > 2 mm beyond annulus
              • Flail leaflet: Eversion of mitral valve leaflet tip into LA
                • Usually caused by ruptured chordae

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Echocardiographic Findings

                      • Angiographic Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Uretsky S et al: Use of cardiac magnetic resonance imaging in assessing mitral regurgitation: Current evidence. J Am Coll Cardiol. 71(5):547-563, 2018
                                        2. Doherty JU et al: ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2017 Appropriate Use Criteria for Multimodality Imaging in Valvular Heart Disease: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Am Coll Cardiol. 70(13):1647-1672, 2017
                                        3. Nishimura RA et al: 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 135(25):e1159-e1195, 2017
                                        4. Myerson SG et al: Determination of Clinical Outcome in Mitral Regurgitation With Cardiovascular Magnetic Resonance Quantification. Circulation. 133(23):2287-96, 2016
                                        5. Uretsky S et al: Discordance between echocardiography and MRI in the assessment of mitral regurgitation severity: a prospective multicenter trial. J Am Coll Cardiol. 65(11):1078-88, 2015
                                        6. ACC/AHA et al: ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 114(5):e84-231; 2006. Review. Erratum in: Circulation. 115(15):e409, 2007. Circulation. 121(23):e443, 2010
                                        7. Enriquez-Sarano M et al: Mitral regurgitation. Lancet. 373(9672):1382-94, 2009
                                        8. Alkadhi H et al: Mitral regurgitation: quantification with 16-detector row CT--initial experience. Radiology. 238(2):454-63, 2006
                                        9. Boudoulas H et al: Mitral valvular regurgitation : etiology, pathophysiologic mechanisms, clinical manifestations. Herz. 31(1):6-13, 2006
                                        10. Westenberg JJ et al: Accurate quantitation of regurgitant volume with MRI in patients selected for mitral valve repair. Eur J Cardiothorac Surg. 27(3):462-6; discussion 467, 2005
                                        11. Braunwald E: Valvular heart disease. In Braunwald E: Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. Philadelphia: W. B. Saunders, 2001
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Mitral regurgitation (MR)
                                                    • Left ventricular stroke volume (LVSV)
                                                  • Synonyms

                                                    • Mitral insufficiency
                                                  • Definitions

                                                    • MR: Incomplete closure of mitral valve (MV) during systole resulting in retrograde blood flow into left atrium (LA)
                                                    • Mitral valve prolapse (MVP): Systolic movement of valve leaflet into LA > 2 mm beyond annulus
                                                    • Flail leaflet: Eversion of mitral valve leaflet tip into LA
                                                      • Usually caused by ruptured chordae

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Echocardiographic Findings

                                                            • Angiographic Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Uretsky S et al: Use of cardiac magnetic resonance imaging in assessing mitral regurgitation: Current evidence. J Am Coll Cardiol. 71(5):547-563, 2018
                                                                              2. Doherty JU et al: ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2017 Appropriate Use Criteria for Multimodality Imaging in Valvular Heart Disease: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Am Coll Cardiol. 70(13):1647-1672, 2017
                                                                              3. Nishimura RA et al: 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 135(25):e1159-e1195, 2017
                                                                              4. Myerson SG et al: Determination of Clinical Outcome in Mitral Regurgitation With Cardiovascular Magnetic Resonance Quantification. Circulation. 133(23):2287-96, 2016
                                                                              5. Uretsky S et al: Discordance between echocardiography and MRI in the assessment of mitral regurgitation severity: a prospective multicenter trial. J Am Coll Cardiol. 65(11):1078-88, 2015
                                                                              6. ACC/AHA et al: ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 114(5):e84-231; 2006. Review. Erratum in: Circulation. 115(15):e409, 2007. Circulation. 121(23):e443, 2010
                                                                              7. Enriquez-Sarano M et al: Mitral regurgitation. Lancet. 373(9672):1382-94, 2009
                                                                              8. Alkadhi H et al: Mitral regurgitation: quantification with 16-detector row CT--initial experience. Radiology. 238(2):454-63, 2006
                                                                              9. Boudoulas H et al: Mitral valvular regurgitation : etiology, pathophysiologic mechanisms, clinical manifestations. Herz. 31(1):6-13, 2006
                                                                              10. Westenberg JJ et al: Accurate quantitation of regurgitant volume with MRI in patients selected for mitral valve repair. Eur J Cardiothorac Surg. 27(3):462-6; discussion 467, 2005
                                                                              11. Braunwald E: Valvular heart disease. In Braunwald E: Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. Philadelphia: W. B. Saunders, 2001